Leanne Woods, instructed by Tim Deeming at Tees Law, appeared for the family in the inquest into the death of MG. MG died, aged only 19, as a result of an aortic rupture.
The Coroner found that he died because of a number of issues that arose in the course of his medical treatment and those issues were missed opportunities to render care that contributed to his death.
MG had a chest x-ray in January 2020 which was reported as showing an enlarged heart. Because of a problem with the computer system at Addenbrooke’s Hospital, the radiologist reporting the x-ray was unaware of a previous x-ray from 2012 which showed a normal sized heart. Had she been aware of this, the enlargement over time would have been included in the imaging report. In fact, because of a further, different, IT error the January 2020 x-ray report was not sent to MG’s GP at all.
When MG saw his GP for follow-up, the GP looked at the 2012 x-ray, not appreciating it was the wrong x-ray and reassured MG. 2 months later a nurse at the GP practice made the same mistake.
The Coroner found that, had the January 2020 report been sent to the GP, MG would have been sent for an echocardiogram. That would have revealed an aortic aneurysm. Lifestyle and safety netting advice would have been given and MG would have been sent for surgery. MG would not have died in July 2020.
Richard Mumford, instructed by Kennedys Law LLP, appeared for the Hospital Trust as an Interested Person.